TMA is your voice on Capitol Hill, your regulatory watchdog, your intermediary with health insurance companies, and your source for legal guidance and interpretation. We advocate for Tennessee physicians every day so you can take care of your patients, and while a lot goes on behind the scenes, you need to know about some of the biggest achievements on your behalf or in your defense.

  1. Maintenance of Certification – TMA persuaded the Tennessee General Assembly to pass the nation’s most physician-friendly MOC laws, which prohibit MOC as a sole condition of state medical licensure, hospital credentialing and/or admitting privileges or health plan network participation.

  2.  Scope of Practice – TMA defeated repeated attempts by APRNs and academic nurses to change state laws to allow for unsupervised practice in Tennessee, including negotiating a three-year moratorium on any scope of practice legislation. TMA continues to promote physician-led, team-based healthcare delivery models.

  3. TennCare Episodes of Care – TMA since 2014 has advocated for improvements to the TennCare episodes of care program design and implementation. TennCare announced in June 2018 that it would pause the episodes rollout and concentrate on improving episodes already in place. We will continue to engage state officials and gubernatorial candidates as physicians’ loudest and strongest advocate on payment reform initiatives.

  4. Opioid Epidemic – TMA has led the way on prescriber education, important public policies and other initiatives to combat Tennessee’s opioid abuse epidemic. We negotiated improvements to Governor Haslam’s TN Together bills in 2018 and developed proprietary resources to educate members on strict new state laws limiting how much doctors can prescribe.

  5. Tort Reform – TMA led the charge for state laws in 2008 and 2011 that created Tennessee’s current favorable medical liability climate and saves Tennessee doctors an average of more than $14,000 per physician, per year compared to pre-2008 liability insurance premiums, and continues to defend those gains in court and the General Assembly.

  6. Liability Climate – TMA defends Tennessee’s caps on noneconomic damages when it is under constant attack. Most recently, TMA defeated a three-year push from an out-of-state group that wanted to dismantle Tennessee’s current system and replace it with a government-run administrative system.

  7. Balance Billing – TMA has defeated numerous proposals that would have eliminated hospital-based physicians’ ability to balance bill patients for services provided out of a health plan network and/or lifted the ban on corporate practice of medicine. TMA continues to lead advocacy efforts for a reasonable solution to “surprise medical bills” that is fair to physicians and patients.

  8. Provider Stability Act – TMA worked for four years to give physicians and other healthcare providers more predictability and stability in their contracts with payers. The Healthcare Provider Stability Act was signed by the governor in 2017 after four years of effort by TMA to hold insurance companies accountable to the network contracts they sign with healthcare providers and limit arbitrary, one-sided rate reductions. The law takes effect January 1, 2019 and is the first of its kind in the U.S.

  9. TennCare Clawbacks – TMA has advocated since 2015 with state and federal legislators, TennCare representatives, and directly with CMS regarding a federally-mandated audit of primary care providers who received enhanced Medicaid payments in 2013 and 2014 under a provision of the Affordable Care Act. Through the audit, TennCare planned to recoup $7.5 million from some PCPs in Tennessee. Thanks to TMA advocacy and a federal class action lawsuit, TennCare is no longer allowed to recoup enhanced payments and physicians in other states are protected from the same scenario with their Medicaid agencies.

  10. Leadership Development – TMA expanded its physician leadership training programs to help doctors excel in their practice environments, in their profession and in their communities. Members have access to different courses from fundamental leadership training to in-depth projects to drive quality improvement, increase efficiencies and reduce costs in the clinical setting.

  11. Payer Hassles – TMA’s insurance advocacy has helped Tennessee doctors avoid or mitigate countless reimbursement and administrative hassles. In 2018, for example, TMA’s efforts helped persuade Amerigroup to rescind a modifier 25 policy that would have paid physicians only 50% of fee schedule for sick patient services delivered same day as a wellness visit.

  12. Group Health Insurance – TMA launched programs to help medical practices save money on health insurance for physicians and their employees, with options for small and large groups to gain more predictability and control over their annual spend.